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Online Student Application

Two easy steps to register
By entering and submitting the form, I am requesting academic accommodations or other services as an individual with disability; as defined by Federal law. Accommodations and services are provided in accordance with Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990; as respectively amended.

I also acknowledge that the Family Educational Rights and Privacy Act of 1974 (FERPA) allows Harper College to disclose certain information about me. Access & Disability Services (ADS) staff, as officials of the College, can disclose information without my consent for legitimate educational purposes. ADS staff will attempt to limit the sharing of disability-related information about me when possible, but will share pertinent information on my behalf when it relates to my educational goals and/or accommodations.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Hint: Enter 9 alpha numeric characters.
  3. Hint: Enter date in the following format Month / Day / Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only (i.e. enter 5417377000 for 541 737 7000).
  2. Hint: Enter 10-digit number only (i.e. enter 5417377000 for 541 737 7000).
Local Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Questions
  1. Disability Information (Select all that apply):
  2. Have you applied for financial aid?
  3. How does your disability affect your reading?
  4. How does your disability affect your spelling?
  5. How does your disability affect your writing?
  6. How does your disability affect your math?
  7. How does your disability affect your understanding of vocabulary?
  8. How does your disability affect your memory?
  9. How does your disability affect your attention/concentration?
  10. How does your disability affect your study habits? (taking notes, studying for exams, etc.)
  11. How does your disability affect your time management/organization?
  12. How does your disability affect your understanding of lectures?
  13. How does your disability affect your ability to take notes?
  14. How does your disability affect your self control?
  15. How does your disability affect your ability to interact with others?
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